Revista Argentina de Cirugía

Usefulness of microbiological bile analysis in grade II cholecystitis according to the Tokyo classification

Tue, 26 May 2026 00:00:00 +0000

Background: The Tokyo Guidelines 2018 for the Management of Cholecystitis (TG18) recommend intraoperative microbiological bile analysis (MBA) in moderate cases (grades II) to identify microorganisms and adjust antibiotic therapy.
Objective: he aim of this study was to describe the results of samples obtained by intraoperative gallbladder aspiration for MBA and its association with comorbidities, PPI use, prior antibiotic therapy, and postoperative complications in patients with grade II cholecystitis.
Material and methods: This observational, prospective and descriptive study included adult patients (> 18 years) diagnosed with grade II acute cholecystitis according to the TG18 managed with laparoscopic cholecystectomy (LC). Patients were assigned to two groups based on a positive or negative MBA. The data analyzed included demographic variables, medical history, and surgical and microbiological characteristics. The chi-square test (χ²) was used to compare categorical variables. A p-value < 0.05 was considered statistically significant.
Results: Of the 272 patients who underwent LC, 51 had grade II acute cholecystitis; 29 (57%) were women, and mean age was 57 years (SD 18). The MBA was positive in 14 (27%) cases. Ten patients had a body mass index (BMI) of 25 or higher, 5 had comorbidities, and 7 used PPIs. None of the patients had received antibiotic therapy prior to hospitalization. E. coli was the most common germ involved (28%). All the germs were susceptible to ceftriaxone. There were no intraoperative adverse events resulting from gallbladder aspiration or postoperative complications.

Soft tissue sarcomas of the extremities and trunk. Surgical and oncological outcomes in patients with local disease

Tue, 26 May 2026 00:00:00 +0000

Background: Local soft tissue sarcomas (STS) of the extremities and superficial trunk require multimodal treatment to achieve local control rates > 80%.
Objective: The aim of this study was to describe the long-term surgical and oncological outcomes of patients with STS of the extremities and trunk with local disease.
Materials and methods: We conducted a retrospective, descriptive and observational study of patients with STS of the extremities and trunk who underwent surgery between 2008 and 2024. Patients were divided into 3 groups: primary tumors (G!), local recurrences (G2) and margin widening following inadequate resections (G3). The clinical and pathological characteristics, type of resection and reconstruction, complications, and adjunctive treatment therapy were recorded. Local recurrence-free survival (LRFS) and overall survival (OS) were evaluated in each group.
Results: A total of 124 patients were included: 61 (49%) in group 1, 37 (30% in group 2, and 26 (21%) in group 3. Median tumor size was 8.5 cm (IQR 3.25-12). All the tumors were completely resected with limb preservation in 98.8%. Reconstructive procedures were performed in 36 cases (29%), with a higher incidence in groups G2 and G3. Radiation therapy was administered to 22 patients in G1, 6 as neoadjuvant therapy and 16 as adjuvant therapy. In G1, 5-year LRFS, distant metastases and OS were 82.8%, 63.5%, and 79.3%, respectively. In G2 and G3, the rates were 61.6%, 75%, and 85.3%.

Short-term outcomes of surgical treatment for retroperitoneal tumors over a 10-year period

Sun, 31 May 2026 00:00:00 +0000

Background: Retroperitoneal tumors are uncommon, and their surgical removal poses a challenge for surgeons, as the space where they develop contains major blood vessels that are often compressed or displaced by the tumor. Sarcomas are the most common retroperitoneal tumors.
Objective: The aim of this study was to evaluate the short-term outcomes of surgical resection for retroperitoneal tumors.
Material and methods: We conducted an observational, retrospective and descriptive study. The medical records of patients who underwent surgery between January 2005 and December 2024 were reviewed. The demographic, clinical and operative variables were analyzed.
Results: A total of 12 patients underwent surgery; 8 had malignant lesions, 7 of which were sarcomas.
There were no deaths in the series and 4 patients developed in 4 cases (33%). Mean length of hospital stay was 6.5 days. An R0 resection confirmed by pathological examination was achieved in 9 patients. Three patients who could be followed up developed tumor recurrences.
Conclusion: Sarcomas were the most common retroperitoneal tumors. An R0 resection was achieved in most cases, with complication rates comparable to those reported in other series.